Predictability in orbital reconstruction

The aim of this thesis is to evaluate the current standards in diagnostics and treatment of orbital fractures. The principles of orbital reconstruction are described and the biggest controversies are debated. By three systematic reviews, the indications in relation to fracture size and location are discussed, as well as the optimal timing and the most suitable biomaterial for orbital reconstruction. In a cadaver study the visual appraisal of a surgeon is evaluated for diagnosing traumatic orbital defects. By introducing a novel method for quantifying the orbital implant position different treatment modalities could be analysed. The quality of the reconstructions is compared between traditional, endoscopic-assisted and navigation-assisted surgery. It can be concluded that computer assisted surgery result in a more consistent and better reconstruction. By adding markers embedded in the implant design the predictability of the reconstruction could be further improved. The application 3D printed (SLS) patient specific implants is evaluated in a clinical cohort. These PSIs allows precise reconstruction of orbital fractures by using a complete digital workflow and should be considered superior to manually bent titanium mesh implants.
As shown in this thesis, with the help of modern technology it could be possible to realize a fail-safe, true-to-original orbital reconstruction.